Patch tests in children with suspected allergic contact dermatitis: a prospective study and review of the literature.
OBJECTIVE
The results of patch testing in children visiting our out-patient clinic with suspected allergic contact dermatitis (ACD) were prospectively investigated and compared with those reported in the literature. A review of the literature on patch testing and ACD in children is provided.


METHODS
Children were patch tested using the TRUE test, supplemented with tixocortol-17-pivalate, budesonide and 3 commonly used emollients. Supplementary patch tests were undertaken on indication.


RESULTS
Seventy-nine children (31 boys and 48 girls) were patch tested. Of the patients tested, 40 (51%) had 1 or more positive allergic patch test reactions. Twenty-two (55%) of these 40 children suffered from atopic dermatitis, 9 (23%) from hand or foot dermatitis, and 9 (23%) from other skin ailments. Nickel was the most common contact allergen, but many other common and less common allergens were noted to give positive patch tests in patients.


CONCLUSIONS
Sensitization to contact allergens may begin in infancy and continue to be more common in toddlers and young children. In recalcitrant atopic dermatitis, especially at the age of 5 years and over, patch tests are indicated. Good information on preventing the development of ACD in children is useful for caregivers.
de Waard-van der Spek
Flora B
FB
Paediatric Dermatology Unit, Department of Dermatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands. f.dewaard@erasmusmc.nl
Oranje
Arnold P
AP
D000293:Adolescent; D000485:Allergens / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D017449:Dermatitis, Allergic Contact / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010328:Patch Tests / Q000379:methods*; D011237:Predictive Value of Tests; D011446:Prospective Studies
D000485:Allergens